Adherence to CPAP Treatment: Can Mindfulness Play a Role?

Pataka, Athanasia; Kotoulas, Seraphim; Gavrilis, Panagiotis Raphael; Karkala, Aliki; Tzinas, Asterios; Stefanidou, Aimiliza

doi:10.3390/life13020296

Cited by 6 publications

(3 citation statements)

References 80 publications

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“…Work should be undertaken to risk stratify those who are unlikely to use CPAP therapy and targeted intervention made for these patients. Work to optimise patient comfort of PAP, for example through optimal mask interface, is ongoing [77], and other interventions such as emotional self-regulation via mindfulness are of interest [78 ▪ ]…”

Section: Future Directionsmentioning

confidence: 99%

Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions

Chambers,

Bamber,

Singh

2023

Current Opinion in Pulmonary Medicine

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Purpose of review Obstructive sleep apnoea (OSA) is an increasingly common pathology that all those involved in perioperative care will come across. Patients with the condition present a challenge at many stages along the perioperative journey, not least because many patients living with OSA are unaware of their diagnosis. Key interventions can be made pre, intra-, and postoperatively to improve outcomes. Knowledge of screening tools, diagnostic tests, and the raft of treatment options are important for anyone caring for these patients. Recent findings Recent literature has highlighted the increasing complexity of surgical patients and significant underdiagnosis of OSA in this patient population. Work has demonstrated how and why patients with OSA are at a higher perioperative risk and that effective positive airways pressure (PAP) therapy can reduce these risks, alongside evidencing how best to optimise adherence to therapy, a key issue in OSA. Summary OSA, and particularly undiagnosed OSA, presents a huge problem in the perioperative period. Perioperative PAP reduces the risk of postoperative complications but adherence remains an issue. Bespoke perioperative pathways should be developed to identify and optimise high risk patients, although at present evidence on how best to achieve this is lacking.

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Section: Future Directionsmentioning

confidence: 99%

Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions

Chambers,

Bamber,

Singh

2023

Current Opinion in Pulmonary Medicine

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“…In children with tonsillar hypertrophy, adenotonsillectomy relieves symptoms in the majority of patients [ 9 ] and is a reliable option if one accepts the associated surgical morbidity and risk of recurrence. Although an effective method in adults, in children continuous positive airway pressure (CPAP) is difficult to implement due to poor compliance [ 10 , 11 ]. Orthodontic correction of class II deformities has been shown to be a valuable option and can be performed either through rapid palatal expansion or through oral devices with promote mandibular advancement.…”

Section: Introductionmentioning

confidence: 99%

Dental Appliances for the Treatment of Obstructive Sleep Apnea in Children: A Systematic Review and Meta-Analysis

et al. 2023

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Background and objectives: Obstructive sleep apnea (OSA) in children is a debilitating disease, difficult to treat. Dental appliances have been proposed as a valid therapy for improving functional outcomes with good compliance rates. Herein, we aimed to perform a meta-analysis comparing clinical outcomes between OSA children treated with dental appliances versus controls. Materials Methods: The study was registered with PROSPERO. A systematic search was performed for all comparative studies examining outcomes in pediatric patients who underwent treatment of OSA with oral appliances versus controls. Data was extracted and analyzed using a random effects model via Rev Man 5.3. Results: Six studies including 180 patients were analyzed split into two groups: patients treated with dental appliances (n = 123) and the controls (n = 119). Therapy with dental appliances was shown to significantly improve the apnea–hypopnea index (p = 0.009) and enlarge the superior posterior airway space (p = 0.02). Maxilla-to-mandible measurements were not significantly different between the two groups, nor was the mean SO2 (p = 0.80). Conclusions: This is the most updated meta-analysis assessing the role of dental appliances for OSA in children; it shows that such devices can improve functional outcomes by decreasing the apnea–hypopnea index.

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“…It is well known that bedtime routines and sleep environment affect sleep quality 21 . Reduced sleep quality, such as increased sleep latency and intermittent awakening may affect tolerance to CPAP therapy 22,23 . Notably, irregularity in sleep-wake rhythm has been reported as a risk factor for various diseases such as cardiovascular disease, hypertension, hyperlipidemia, and diabetes [24][25][26] .…”

mentioning

confidence: 99%

The association between irregularity in sleep-wake rhythm and CPAP adherence

Honma,

Nohara,

Honma

et al. 2024

npj Biol Timing Sleep

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This study aims to evaluate the association between sleep-wake rhythm regularity and continuous positive airway pressure (CPAP) adherence. We retrospectively analyzed sleep-wake rhythms with activity monitoring and CPAP adherence among obstructive sleep apnea (OSA) patients newly diagnosed and introduced to CPAP therapy at the Sapporo Hanazono Hospital from January 2018 to June 2022. Among a total of 45 patients, 10 withdrew from CPAP therapy within a year. Nineteen were classified into the good-adherence and 16 into the poor-adherence group. No significant differences were detected among the groups in apnea-hypopnea index (AHI), sleep efficiency, or subjective sleep quality, but a difference was observed in sleep latency, with the CPAP withdrawal group showing higher variability in sleep onset and lower regularity and/or amplitude in circadian behavior activity rhythm than the good-adherence group. Our results suggest that irregularities, particularly in sleep onset, and damped sleep-wake rhythm can be risk factors for CPAP withdrawal.

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Adherence to CPAP Treatment: Can Mindfulness Play a Role?

Cited by 6 publications

References 80 publications

Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions

Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions

Dental Appliances for the Treatment of Obstructive Sleep Apnea in Children: A Systematic Review and Meta-Analysis

The association between irregularity in sleep-wake rhythm and CPAP adherence

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